The need for alternatives in chronic wound care has been identified. Products available in the chronic wound care market have been developed to shorten the “episode of care” associated with managing hard-to-heal wounds. An increased awareness of moist wound healing, particularly the chronic wound care has also developed significantly over the last few years in both the public and private healthcare sectors.
Chronic wounds are identified as wounds that are unable to heal by primary intervention, and are assessed on three major indices:    a) exudate level,    b) tissue types present; and    c) depth of wound.
Other important factors include the presence of infection, underlying disease aetiology, the patient's general condition, and co-existing disease or medications.
In relation to chronic wound care, two main categories of wounds can be recognised with which appropriate wound care products as described by the present application would be applied. These two main categories are:    a) exudating wounds that are not infected; and    b) exudating wounds that are infected.
The majority of chronic wounds fall within the first category. These wounds may be managed by moist wound healing principles, although the healing process is not complicated by infection.
The second category includes chronic wounds that will not heal until complete eradication of the infection has first been achieved. Accordingly, within this category of wounds, wound healing is not the primary aim. However, once the infection is under control, non-active healing products are generally used.
This second category of wounds is among the hardest sector to treat, whilst there is a wide range of products used both topically and systemically for clearing wound infections, (including iodine-based preparations and so forth), the main therapeutic intervention for infective wounds however, is the use of systemic antibiotics.
However, existing antibacterial treatments may have varying effectiveness, and some have been shown to cause tissue damage and slowing down of the healing process. Honey on the other hand, appears to actually promote the healing process with no corresponding tissue damage. Historically, honey has been identified as having healing properties. Recently however, anti-microbial properties of certain honey and their potential use in wound care have attracted attention.
In New Zealand, the “unique Manuka factor” (UMF™) activity identified in Manuka tree-based honey products, and in other active honey products produced from the plant species Leptospermum, has been identified to be useful in relation to infected wounds. Although, ordinary honey may nevertheless also have application for non-infected wounds.
The beneficial properties of some particular honeys, (particularly Manuka honey) include both its anti-bacterial, non-peroxide activity, as well as its peroxide activity. The non-peroxide anti-bacterial activity of these honeys has been shown to inhibit the growth of various species of bacteria and limit the production of the undesirable bi-products of bacterial growth. Honey with at least 10% non-peroxide activity (10% phenol equivalent) demonstrates such therapeutic value.
Whilst the application of honey to wounds is known within the prior art, the use of honey in relation to dressings applied to wounds is still developing.
However, it is important when a dressing is applied to a wound that the dressing itself does not stick to the wound. When the dressing is removed, any healing that may have begun, in terms of skin replacement and so forth may be undone where the surface of the skin sticks to the dressing and is removed when the dressing is removed. As can be appreciated this delays the healing process and recovery overall.
However, healing processes will not usually occur unless infection is cleared from the wound.
Honey based products, particularly UMF™ honey, play a role in managing infected wounds when applied or used in conjunction with appropriate dressings. Honey based wound dressings inherently have a number of properties that lend them to use as general chronic wound care dressings in particular. These properties include:    a) osmotic absorption of excess exudate; and    b) inherent peroxide (antibacterial) activities; which is both wound cleansing and helps with wound bed oxygenation; and    c) provision of beneficial nutrients to the wound bed.
Whilst honey can be applied to an area, the usual fluidity of honey has made localised application difficult. Even the use of absorbent material (such as existing bandages or gauzes), have not successfully addressed inherent difficulties relating to the application of honey to, and its maintenance on, the wound area. Given exudating wounds exacerbate this problem the need is identified to produce an appropriate dressing in conjunction with honey in a form that overcomes the above problems.
In addition, to facilitate wound healing it is preferable that the honey be of a preferred viscosity (whether achieved via specific processing of the honey or not) and/or include concentrated beneficial properties.
It would also be beneficial to make maximum use of the hygroscopic characteristic of honey—(capable of absorbing moisture from the air) that provides an advantage to using honey in moist wound care.
Therefore, it would be advantageous to develop the use of honey-based wound dressings that may be used:    a) in relation to the care of chronic wounds, including non-infected as well as infected wounds; and    b) to meet the requirements of moist wound care practices; and    c) to promote the healing barrier, as opposed to the use of dressings which when removed may delay overall healing; and    d) including honey-based products containing higher proportions of active and/or honey with preferred properties; and    e) in the care not only of wounds, but also burns and skin ulcers for more rapid healing, with minimal scarring.
Modern hydro-colloid wound dressings are presently favoured as moist dressings, although such wound dressings are expensive. Foams, gels and alginates are also available for treating chronic wounds. However, whilst moist wound care enhances the healing process through tissue re-growth, such moist conditions favour the growth of infecting bacteria.
The use of honey in conjunction with dressings has shown however that infecting bacteria are disadvantaged.
It is an object of the present invention to at least provide a wound dressing with which honey is used that addresses the above-mentioned problems, and/or provide the public with a useful choice.
Further aspects and advantages of the present invention will become apparent from the ensuing description which is given by way of example only.